posted March 27, 2009 08:08 AM         

Menopause & perimenopause
Perimenopause — the beginning of hormonal change

by Marcelle Pick, OB/GYN NP

Up until relatively recently, conventional medicine has had little to offer women suffering from symptoms of hormonal change. Until a woman was deemed to be officially in menopause and could be prescribed synthetic hormone therapy, she was often told that her symptoms were all in her head. Even today, women struggling with hormonal imbalance are frequently sent home with a prescription for antidepressants, rather than being offered real solutions for a very real condition.

In integrative medical circles, there has long been recognition that a transitional period of time exists before menopause, which is different for each woman, when fluctuating hormones may cause her serious distress. Thankfully, conventional medicine has caught up and we now have an official name for this passage in medical textbooks: perimenopause — defined as a transition period that precedes menopause, as in “pre-menopause,” which is symptomatic of hormonal imbalances and fluctuations in a woman’s body.

Symptoms of perimenopause can begin as early as 10–15 years before menses completely stop. Women in their late 30’s, 40’s and early 50’s may transition in and out of a perimenopausal state many times before they finally enter menopause. If you are currently experiencing symptoms such as irregular periods, heavy bleeding, hot flashes, sleep disruption, headaches, dry eyes, vaginal changes, hair loss, weight gain, loss of libido or extreme emotional distress, you may be relieved to know that these are all common signs of perimenopause.

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Along with the more obvious changes listed above, many of my perimenopausal patients find their short-term memory impairment or a lack of focus to be very irksome. These cognitive effects of hormonal imbalance are frequently overlooked in mainstream discussions about perimenopause. Yet fuzzy thinking and an inability to multitask can definitely be traced to your physical state, as can increased anxiety, fatigue, depression and drastic mood swings. These symptoms are actually signals being thrown up by your body to make you stop in your tracks and take notice. Women often remark on the brain fog that comes over them after childbirth, affording them only the attention span to focus on their new baby. A similar phenomenon occurs with the hormonal fluctuations leading up to menopause — only this time the miasma of your hormones is telling you to stop and pay attention to yourself!

It may be reassuring to remember that a woman’s body is always in flux, always changing, and never more so than in the years that characterize puberty and perimenopause. In the same way you can be “pubescent” you can also be “perimenopausal.” But these are just words, not a rigid definition of who you are, what your body is capable of, or who you are going to be.

During perimenopause, the ratio of estrogen to progesterone is frequently in a state of flux, which can manifest along with other symptoms as very heavy (and maybe even frightening) bleeding. In our culture, many women tend to be operating with an internal hormonal balance tipped toward the estrogen side of the scale. This tilt is often the result of a diet high in simple carbs and low in quality protein, a lack of essential nutrients and fats, and chronic exposure to environmental toxins and artificial hormones such as endocrine disruptors. Prolonged emotional and physical stress, which I define as anything that works against your state of balance, will also upset the hormonal applecart. In today’s fast-paced, disconnected, eat-and-run world, it is no surprise to me that younger and younger women are coming in to my practice with symptoms of hormonal imbalance and perimenopause.

In some cases, women in perimenopause may have low levels of progesterone in comparison to their estrogen levels. In other cases, the progesterone level is fine, but estrogen levels are too high. Another case we are seeing more frequently is where all three of the key hormones which flux during this time, estrogen, progesterone and testosterone, are too low. What’s most important to recognize is that each woman needs to be evaluated differently, preferably by a medical practitioner conversant in integrative or alternative medicine. More often than in the past I find conventional doctors are quite willing to discuss the reality of perimenopause, but natural, long-lasting solutions are still hard to come by. Most conventional practitioners don’t believe that people can change their lifestyle and eating habits. My response is that I know and have seen that they can. And I will tell you this: no woman needs to suffer with symptoms of hormonal balance, at perimenopause, menopause, or after menopause. You can feel better and you can start right now.

Being in perimenopause does not necessarily mean that you will follow an immediate and direct path to menopause. Some women go for years in this transitional state, whereas others sail through in just a few months. What does seem to influence the severity of symptoms is the weight of other burdens women may have placed on their bodies over the years. Poor nutrition, chronic stress, and a lack of daily exercise are three major amplifiers because they each play a significant role in the body’s ability to detoxify and maintain homeostasis. Lifestyle choices such as smoking or drinking to excess are likewise compounding factors.

Another hidden element of perimenopause is fear. Many women are terrified by the prospect of losing their biological fertility, just when stress and low testosterone may be zapping their libido. Our youth-obsessed culture has been extremely hard on aging women, but I have witnessed the dynamic transformation that takes place in my patients. The joys of life after menopause are many and great — you just have to learn how to manage the symptoms leading up to it!

After more than 20 years of helping women with their premenopausal issues, I understand firsthand women’s frustration with the way healthcare is often delivered. With projections indicating that for the first time in history our children’s life expectancy may be shorter than our own, the time is ripe to make some changes in the way we care for ourselves — changes that aren’t oriented toward drugs. I’ve found that a combination approach, one that takes into account all four corners of a woman’s foundation of health, provides the most relief. That’s why I created the Personal Program to give women the basic tools necessary to navigate the confusing waters of perimenopause: in short, optimal nutrition, hormonal balance, mindful exercise habits, and emotional support.

By taking our Essential Nutrients and using our Herbal Equilibrium as directed, members have taken the initial steps toward healing their bodies and restoring their natural hormonal balance. Frequently they then find the energy and will to make lifestyle and dietary changes that dramatically improve their quality of life. Many write to us to describe their transformation. I encourage you to read these women’s stories for yourself and learn more about your health in our health topics library.

posted March 27, 2009 09:22 AM         

I definitely have something going on hormonally, a severe imbalance (?)... and it's not fun. I'm tired of the wild rides.
Seems by this article's criteria I'm a little young for perimenopause but i wont rule it out just yet...

posted March 27, 2009 03:26 PM         

I've been reading Black Cohosh can help, though not always it is controversial because of it's estrogenic inducing activity. Also Vitex (which I actually once tried and i'm not sure if it made my next period worse or it was going to be anyway, but i discontinued taking it) also I think Red Clover is supposed to help. Will share anything else i find.

posted March 27, 2009 03:31 PM         

Fibroids

Endometriosis

posted March 27, 2009 03:38 PM         

"in which endometrial cells are deposited in areas outside the uterine cavity."

posted March 27, 2009 03:38 PM         

26taurus...endometriosis can get into any part of one's body.
No fun.

posted March 27, 2009 03:45 PM         

quote:

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often i've thought this is what might make me vomit so hard and much (maybe being deposited in my stomach). body wants something out, even when there's nothing in it.

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